Error message

  • Deprecated function: implode(): Passing glue string after array is deprecated. Swap the parameters in drupal_get_feeds() (line 394 of /var/www/indicatorregistry/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6656 of /var/www/indicatorregistry/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6656 of /var/www/indicatorregistry/includes/common.inc).

Needles and syringes distributed per person who injects drugs

Export Indicator

Number of needles and syringes distributed per person who injects drugs per year by needle-syringe programmes
What it measures

Progress in improving the coverage of needles and syringes provided, an essential HIV prevention service for people who inject drugs

Rationale

Injecting drug use is the main route of transmission for about 12% of people acquiring HIV globally. Preventing HIV transmission caused by injecting drug use is one of the key challenges in reducing the burden of HIV.

Needle-syringe programmes are one of nine interventions in the World Health Organization (WHO), United Nations Office on Drugs and Crime (UNODC) and UNAIDS comprehensive package for the prevention, treatment and care of HIV among people who inject drugs.

Needle-syringe programmes greatly enhance HIV prevention for people who inject drugs, and a wealth of scientific evidence supports their efficacy in preventing the spread of HIV.

Numerator

Number of needles and syringes distributed in the past 12 months by needle-syringe programmes

Denominator

Number of people who inject drugs in the country

Calculation

Numerator/denominator

Method of measurement

For the numerator: Programme data used to count the number of needles and syringes distributed

For the denominator: Estimation of the number of people who inject drugs in the country

Measurement frequency

Every two years

Disaggregation
  • Type of provider (public services, key population-led organization, NGOs, or other entities). Please see page 31 for additional guidance.
  • Name of the organization/s. Please indicate the name and URL/website (if available) of the key population-led organization, NGOs, or other entities that are providing these services.
  • Cities and other administrative areas of importance. If there are subnational data available, please provide the disaggregation by administrative area, city, or site in the space provided. You may also upload an Excel spreadsheet of these data instead of entering them in the online tool. Submit the digital version of any available size estimation reports using the upload tool.
Additional information requested

If there are subnational data available, please provide the disaggregation by administrative area, city, or site in the space provided. Submit the digital version of any available survey reports using the upload tool.

Strengths and weaknesses

Some difficulties in counting needles and syringes are reported. Some commonly used syringes are 1-ml or 2-ml needle and syringe units; others are syringes to which needles need to be fitted. In most cases, only data on the number of syringes distributed by needle-syringe programmes but not pharmacy sales are available.

Estimating the number of people who inject drugs at the country level presents challenges. People who inject drugs are defined in many ways, and the estimates have ranges. The UNODC publishes estimates of the number of people who inject drugs in the World drug report. These estimates may be used. If there is a reason not to use them, please provide the rationale in the comment field.

Countries that have legalized sales of needles and syringes without a prescription may appear to have artificially low coverage with this indicator. Countries can monitor this indicator against the following coverage levels:

  • Low: <100 syringes per person who injects drugs per year.
  • Medium: 100–200 syringes per person who injects drugs per year.
  • High: >200 syringes per person who injects drugs per year.

These levels are based on studies in low- and middle-income countries investigating the levels of syringe distribution and how these affect HIV transmission. The levels required for preventing hepatitis C are likely to be much higher than those presented here.

 

Further information
The following fully describes this indicator: World Health Organization, United Nations Office on Drugs and Crime, UNAIDS. Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Geneva: World Health Organization; 2012 (http://www.unaids.org/sites/default/files/sub_landing/idu_target_setting...).
 
Needle and syringe programmes, In: who.int [website]. Geneva: World Health Organization; c2019 (http://www.who.int/hiv/topics/idu/needles/en/index.html).
 
Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among IDUs. Geneva: World Health Organization; 2004 (http://www.who.int/hiv/pub/idu/e4a-needle/en/index.html).
 
WHO/UNAIDS Working Group on Global HIV/AIDS and STI Surveillance. Guidelines on estimating the size of populations most at risk to HIV. Geneva: World Health Organization and UNAIDS; 2010 (http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiolo...
Estimating_Populations_en.pdf).
 
Consolidated HIV strategic information guidelines: Driving impact through programme monitoring and management. Geneva: World Health Organization, 2020 (https://www.who.int/publications/i/item/consolidated-hiv-strategic-infor...).
 
Global HIV Strategic Information Working Group. Biobehavioral survey guidelines for populations at risk for HIV. Geneva: World Health Organization; 2017 (https://www.who.int/hiv/pub/guidelines/biobehavioral-hiv-survey/en/).

Related Indicators

KP.2 Needles and syringes distributed, 2020, WHO Consolidated HIV strategic information guidelines: driving impact through programme monitoring and management (https://www.who.int/publications/i/item/consolidated-hiv-strategic-information-guidelines).